Progress Illinois

The Families USA report isn't the only discouraging news on the health care front here in Illinois. A study recently released by the Agency for Healthcare Research & Quality (part of the Federal Health and Human Services Department) analyzed over 100 separate metrics and concluded that the quality of health care in Illinois is getting worse. As the illustrations here show, on 10 of the 12 major "indicators," the state's performance decreased between 2005 and 2006.

On Chicago Public Radio's Eight Forty-Eight this morning, Dr. Quentin Young discussed some possible reasons for this slip. Among the causes he cited were the dwindling number of primary care doctors in the state, and of course, the growing lack of health insurance:

YOUNG: Geography is important. There are a lot of people in this state outside of Cook County, but they're spread very thin. And downstate facilities have constantly gone down. For example, obstetrical care is frequently 30 or 60 miles away. Some of the arguments are that the malpractice costs have made that happen. It's possible, because an OB-GYN can be charged $100,000 to $150,000 just to open his door. There's more to malpractice issues than that, but it's out there.

Another one, I think, is the shift toward specialism. This state, like many, has a hypertrophied specialized group -- meaning, these are people who do things -- surgeons, gastroenterologists -- who are 70 percent of our doctor force. And only 30 percent are primary care, who would be defined as general internists, family practicioners, OB-GYN -- some OB-GYN -- and all pediatrics. There are only 30 percent. Should be 50, probably 60. I think that's a big factor because these performance measures describe what primary care doctors do a lot. And if there are fewer of them, it's going to fall down.

And then, of course, there's always the issue of ability to pay, which has certainly gotten worse between these two surveys. That is to say, people in larger numbers have no insurance or poorer insurance.

I think that would begin to subsume the explanation. Althought this study does not offer the why of it, they just give you the what.